We’ve all heard the story of how George Washington’s demise was likely hastened by the amount of blood that was purposely extracted from him by his physicians as he lay critically ill with pneumonia. At least one of the late President’s doctors later opined as much. But bloodletting, whether by instruments or leeches, was a widely accepted practice for all matter of ailments in Western medicine well into the 19th century.
I was nonetheless taken aback recently when I read this account in the Lancet of an early 19th century bloodletting on a trauma victim, perhaps surprised all the more because he survived!
On 13 July 1824, a sergeant in the French army was stabbed in the chest while engaged in hand-to-hand combat. Though he was carried to the surgeon’s tent as soon as possible, within minutes he fainted from the loss of blood. He was immediately bled twenty ounces (570 ml) “to prevent inflammation.” During the night he was bled another 24 ounces (680 ml). Early the next morning, the chief surgeon bled the patient another 10 ounces (285 ml); during the next 14 hours, he was bled five more times. Medical attendants thus intentionally removed more than half of the patient’s normal blood supply – in addition to the initial blood loss which caused the sergeant to faint. Bleedings continued over the next several days. By 29 July, the wound had become inflamed. The physician applied 32 leeches to the most sensitive part of the wound. Over the next three days, there were more bleedings and a total of 40 more leeches. The sergeant amazingly recovered despite his treatment and was discharged on 3 October.
His physician wrote that “by the large quantity of blood lost, amounting to 170 ounces [nearly eleven pints] (4.8 liters), besides that drawn by the application of leeches [perhaps another two pints] (1.1 liters), the life of the patient was preserved.”
Apparently, by 19th century standards, thirteen pints of blood taken over the space of a month was a large but not an exceptional quantity. The medical literature of the period contains many similar accounts – some successful, some not.
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